title: Methods to increase muscle tonus of upper airway to treat snoring: systematic review.
abstract: BACKGROUND
  Snoring is the noise caused by vibration during the in-breath; and which structure actually vibrates depends on many factors.
  
  
  OBJECTIVE
  The treatment of snoring with methods to increase muscle tonus of upper airway has been controversial, and poorly reported, thus a review of evidence is necessary to evaluate the effectiveness of these methods.
  
  
  METHODS
  A review of randomized or quasi-randomized, double blind trials on snoring treatment that have employed any method to increase muscle tonus of upper airway like phonotherapy or physical therapy among others.
  
  
  RESULTS
  decrease or completely stop of snoring, sleep quality, quality of life, and adverse events.
  
  
  RESULTS
  Three eligible trials were potentially analyzed, but none of them could provide good scientific evidence favoring the intervention. The objective analyses of one study showed improvement of snoring, although the objective sub-analyses and subjective analyses showed controversial results. The adverse events were not reported.
  
  
  CONCLUSIONS
  There is no enough evidence to support the recommendation of methods to increase muscle tonus of upper airways in treatment of snoring. Well designed randomized clinical trials are needed to asses the efficacy of such methods, and a standard and worldwide accepted method for snoring assessment would be useful for future researches.
authors.affiliation: Department of Emergency Medicine and Evidence Based Medicine, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Juliana Spelta
authors.initials: JS
authors.lastname: Valbuza
authors.forename: Márcio Moysés de
authors.initials: MM
authors.lastname: Oliveira
authors.forename: Cristiane Fiquene
authors.initials: CF
authors.lastname: Conti
authors.forename: Lucila Bizari F
authors.initials: LB
authors.lastname: Prado
authors.forename: Luciane Bizari Coin de
authors.initials: LB
authors.lastname: Carvalho
authors.forename: Gilmar Fernandes do
authors.initials: GF
authors.lastname: Prado
mesh_terms: D001945:Breathing Exercises; D005081:Exercise Therapy / Q000379:methods; D006801:Humans; D009129:Muscle Tonus / Q000502:physiology*; D016032:Randomized Controlled Trials as Topic; D012132:Respiratory Muscles / Q000503:physiopathology*; D012913:Snoring / Q000503:physiopathology / Q000628:therapy*